Healthcare Provider Details

I. General information

NPI: 1679537310
Provider Name (Legal Business Name): TOWN OF LIMINGTON MAINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 SOKOKIS AVE
LIMINGTON ME
04049-9999
US

IV. Provider business mailing address

PO BOX 1810
WINDHAM ME
04062-1810
US

V. Phone/Fax

Practice location:
  • Phone: 207-637-2171
  • Fax:
Mailing address:
  • Phone: 207-892-0020
  • Fax: 207-893-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number420
License Number StateME

VIII. Authorized Official

Name: MR. MIKE HARTFORD
Title or Position: RESCUE CHIEF
Credential:
Phone: 207-637-2171